Apparatus for ensuring the inhalation of a gas



4 Sheets-Sheet 1 R. E. ROCHETTE ET AL INVENTORS RENE ETIENNE ROCHETTE RENE o uorAuu' BY ATTO NEYS APPARATUS FOR ENSURING THE INHALATION OF A GAS Filed March 19, 1945 III Aug. 1, 1950 1, 1950 R. E. ROCHETTE ETAL 2,517,241

APPARATUS FOR ENSURING THE INHALATION OF A GAS Filed March 19, 1945 4 Sheets-Sheet 2 INVENTURS RENE ETIENNE ROCHETTE RENE DALIOcAULT BY A EM ATTURNE YS 2,517,241 APPARATUS FOR ENSURING THE INHALATION OF A GAS Filed March 19, 1945 R. E. ROCHETTE ETAL 4 Sheets-Sheet 4 L ww m NEE T L A ER m R m \\&\-\k Q Patented Aug. 1, 1950 APPARATUS FOR EN SURING'THE INHALATION OF A GAS ,Ren'fEtienne Rochette, Montfort-le-Rotrou, and Rene Daligault, Paris, France Application'March 19, 1945, Serial No. 583,504 In France January 6, 1944 2 Claims.

The present invention relates to apparatus for ensuring the inhalation of a gas ore, gaseous mixture and it is .more especially, although not .exclusively, concerned with apparatusior the inhalation of anaesthetic gases or mixtures of these gases with oxygen or air.

The object of the present invention is to provide anapparatus of this kind which is easier to adjust than those made up to the present time :and which permits of ensuring rebreathing in 1a simplemanner.

A preferred embodiment of the presentinventionwill be hereinafter described, with reference to the accompanying drawings,,given merely by way of example, and in which:

Fig. 1 is a transverse section, on the line 1-1 .of Fig. 2, of an apparatus made according to the present invention;

Fig. 2 is a sectional view, the left-hand side ,on the line II1--II1 of Fig. l, and the right-hand side on the line II2II2 of Fig. 1, ofthe sameappa- .ratus;

Fig. 3 is a sectional view on the line III-III of Fig. .2, this view also showing the breathing mask and the adjusting means associated therer with;

Fig. 4 is front view on a reduced scale of the same apparatus;

Eigsfi and .6 ,are lateral views showing them-- sitions that maybe given to elements or said adjusting means;

,Figs. 7 and 8 diagrammatically show, one reduced .sca'le, two positions of the deformable device of the apparatus, as taken during ran'anal- .gesia operation;

Figs. '9 andlO are views similar to Figs. '7 and 8, but corresponding to an anaesthesia operation.

In the following description, it 'will be supposed that the apparatus according to the invention is used for causing a patient to inhale an anaesthe'tic gas, such as nitrogen protoxide. v

First, it should be reminded that it is known to make use of such a gas (either alone or in mixture with oxygen, air, carbonic acid gas, or any other suitable fluid) for obtain'inga moreor less intensive anaesthetic action,

When it is desired to obtain a mere analgesic effect, the patient is caused to breathe a mixture =of "anaesthetic gas and :al! in suitable proportions, the dosing :being obtained by .meansiof .a deformrable membrane subjected to the action :of the suction :due 'to inspiration :and acting upon 'a suitable distributing valve. :Inthiscase, expira- Etion takes place directly into the atmosphere.

Qnrthe contrary, if it is desired to 'obtainlanaes- .2 .thesia, the patient is .caused to breathe ,a pure anaesthetic gas :or -;a mixture consisting chiefly (of such ages with oxygen, carbonic acid gas, and so on. In this case, it is advantageous to permit 5 but a partial expirationinto the atmosphere ,of

the gases that have been inhaled, so as :to .obtain rebreathing, by combination with .a chamber. of

variable volume, account being .taken of the variations of volume1ofithe gases.

According to the present invention, the appa- .-r,a.tus includes means not only -i or controlling the flow of gas to the patient in accordance with the inspiration intensity, but also for modifying the 5 relation between this intensity and the rate .of flow.

Itis :possible, with-such anapparatus, to obtain diiferent operational processes, which may -.cor-- respond to different physiologicaliefiects.

.In particular, according to an advantageous eature of the present rinvention. it ispossible, with the same apparatus, to obtain at will either analgesia, or anaesthesia, the latter preferably with rebreathing.

For this P mose, the apparatus according to the present invention essentially includes the fol:- lowinglelements:

to) at least one distributing valve vmeans .for controlling the .feed LOf gas irom a feeding chamher at relatively low pressure;

.(b') a deformable system :for operating said valve means by deformations or displacementsni' elements of .saidsystem caused by pressure vari- .ations created by the .patientis breathing; and

-1(c) ,means for adjusting at will the relation, :for instance "the relative ,position, of said valve means and said deiormable system.

Concerning the deformable system, it seems advantageous "to give it a bellows-like structure.

In this .case, when --the apparatus is to be used for analgesia, the adjusting means are fixed .in such manner that openingand closingof the ,dis .tributing valve .means take place vfor relatively fiatpositions of the bellows.

When anaesthesia is .to be performed, the means ,inquestion .are fixed in such manner that these opening and closing operations correspond to inflatedstatesiof .the bellows, the degree of ..in- .flatihg varying according to the amount of .re breathing to be obtained.

.According .to the specific embodiment illustrated by the drawings, the apparatus, in order to be'fed withgasirom a bottlesuchas l,,,is ,provided with a pressure relief .device ,2 of ,any suit- :55 able type through-which the :final pressure of downstream side of this needle valve (which pres I sure will generally be but little different from the pressure of the surroundingatmosphere) a given rate of flow, which will be advantageously indicated by a suitable meter, for instance of the kind including a glass tube l of conical shaped inner section, inside which a kind of fioat 5 can move along a graduated scale 6.

This meter (or the whole of this meter and control valve 3) is advantageously mounted in a removable manner between tube 1, which leads {from the pressure relief device and tube 8 which leads to the distributing valve means now to be described.

This distributing valve means is, for instance, essentially constituted by'alift valve 9 cooperating with a spring l6 and provided with a push piece H. Valve 9 is operated by a bellows device subjected to the action of the patients breathing,

and according to the present invention the action of said bellows device on the valve is adjustable at will. For instance, in'the embodiment illustrated by the drawing, the position of the bellows with respect to the valve can be modified at will, 5

'for instance vertically, so that the valve is acted upon by the bellows for different states of deformation of the bellows:

'In the example shown by the drawing, the bellows is carried by a support of adjustable posi- "tion, such for instance as a stirrup l2, the displacements of which are controlled, through a screw [3 operated from the outside by means of "a knob 39, adapted to coact with any suitable graduated scale.

Asfor the bellows to be carried by this support, is for instance constituted by two rigid plates I4 pivoted at I5 to stirrup'l2 and connected together (laterally as well as'at the top and bottom) jby flexible, preferably elastic, sheets, for instance rubber sheets l6. i

' Advantageously, each rigid element 14 is constituted by two plates of a light metal between the edges of which (these edges being preferably curved) rubber sheets "it; are tightly caught, in such manner as to ensure perfect fluidtightness. The elements for transmitting to valve 9, or rather to the push rod l l thereof, the movements from said bellows are constituted, in the example shownby the drawings, by triangular plates ll fixed to plates hi at right angles thereto. For a given position of said plates Hi (depending upon the adjustment of stirrupl'Z) these parts I'll come into contact with push rod H, or an element .rigid therewith,,so as to cause valve 9 toopen. In the embodiment illustrated by the drawing, the apparatus is fed with two different gases for instance nitrogen protcxyde and oxygen) supplied by two gas bottles. The apparatus therefore includes two groups of dosing and distrib uting elements as above described, and in particular two valves such as 9. The push rods of these two valves are preferably connected together by a small bar l3 at right angles thereto and which is the element acted upon by triangular plates l1. But it should be well understood that each of the valves might be actuated independently, means being provided with each of said valves for separately adjusting them, so as to permit, if so desired, or modifying the relative proportions of the two gases.

In the embodiment shown by the drawings, stirrup I2 is fixed, at its middle part, to screw 13, through which it can be displaced for adjusting it relative position, and its ends are guided by rods I9 provided with springs 20.

Concerning the receiver apparatus, that it to say the apparatus intended to be fed by the gas or gases flowing out from the bellows at 2|, they are made in any suitable manner, being preferably provided with means for adjusting the proportion of air to be admitted. These apparatus should also include means for permitting at will either to ensure free expiration into the atmosphere (for instance for analgesia) or partly to oppose this expiration in order to produce partial return to the bellows (for rebreating, in the case of anaesthesia) the end of a tube 25 on which the mask is fixed.

This orifice 24 is for instance formed in the end of a tube mounted inside tube 25, as it will be hereinafter described.

The size of this orifice 24 is chosen such as normally to ensure, for analgesia, the inflow of a volume of air sufficient for maintaining a suitable hematosis without physiological perturbation (the diameter of this orifice 24 being for instance of 24 millimeters). It permits the inflow of air to be mixed with the gas from the bellows and the outflow of expiration gases to the atmosphere, when the apparatus is to be used for ensuring analgesia.

Preferably, we further provide a supplementary and adjustable air intake, constituted for instance by a rectangular (or other) aperture 26 in tube 25, adapted to cooperate with an aperture, for instance of triangular shape, 21 provided in a tube 28 fitting inside tube 25 and rotatable with respect thereto, this tube 28 being operated at 29, for instance. As above indicated, orifice 24 is formed in the end 30 of this tube 28. With an arrangement of this kind, the amount of additional air is more or less important according to the relative positions of tubes 25 and 28.

In' order to permit of partly opposing expiration (for instance to obtain anaesthesia and rebreathing), the air flowing in through orifice 24 can be compelled to lift an inlet valve against the action of a spring of suitable, eventually adjustable, strength. This valve may be constituted by a flat disc 3| and the end 30 of tube 28 constitutes the seat of this valve. Disc 3| is guided by means of a rod 32 extending through said seat and it is subjected to the action of a.

spring 33 which tends to apply it against its seat.

In order to permit operation of the-apparatus for analgesia purposes despite the presence of this valve, disc 3| is pivotally mounted about its axis, that is to say about rod 32, and it is fitted with an aperture 34. It will be readily understood that, with such an arrangement, when orifice 24 and aperture 34 are in register with each other (Fig. 5) the inflow and outflow of air are wholly free. This corresponds to analgesia. On the contrary, if these two orifices are brought out of coincidence (Fig. 6) check valve 3| permits the inflow of air but prevents any outflow. This position corresponds to anaesthesia.

Finally, it should be noted that mask 23 is preferably mounted in a removable manner on tube 24, for instance between two plates 36 and 31. It should be well understood that the mask may be of any kind whatever, intended to be applied on the nose, both the nose and the mouth, etc. It might be replaced by any other instrument adapted to permit the passage of the anaesthetic mixture (tubes and so on).

This apparatus works as follows:

To begin with, the operator opens pressure relief devices 2, then valves 3, in such manner as to obtain a suitable rate of flow, which is indicated by the meters, valves 9 being supposed to be open (which can be obtained by suitably adjusting screw l3) If it is desired to obtain analgesia, stirrup I2 is brought into a relatively low position by means of screw I3, as shown by Figs. '7 and 8. When the patient is not breathin through the apparatus, the flaps of the bellows are in a position such as that shown by Fig. 1, for which position the valves 9 remain closed. As soon as the patient starts breathing, flaps I4 are urged by the suction corresponding to inspiration into the position illustrated by Fig. 8, thus opening valves 9 and causing a certain amount of gas to pass through the apparatus toward the breathing mask. At the same time, air is sucked in through orifice 24, which is supposed to be free from the action of check valve 3| (position illustrated by Fig. 5), On the next expiration, the gases flowing out from the patients respiratory apparatus are evacuated to the atmosphere through this orifice and flaps l4 come back to their initial position (Fig. 7). The same cycle of operations is then repeated.

On the contrary, if it is desired to obtain anaesthesia, valve 3| is brought into the position shown by Fig, 6, and screw I3 is operated to brin stirrup l2 in a relatively high position. This immediately causes valves 9 to open and gas is fed to the chamber formed by the bellows.

This gas is sucked in by the patient and, upon the next expiration, returned, at least partly, into the bellows with the breathing products, which tends to increase the space between flaps [4, thus causing valves 9 to close. The mixture thus formed is rebreathed, which may bring about a reopening of valves 9, and so on.

It should be further noted that rebreathing can be adjusted by suitably positioning stirrup l2 and can therefore be made more or less complete. It depends, in a general way, on the one hand upon the strength of spring 33, which opposes the opening of valve 3|, and, on the other hand upon the possibilities of expansion of the bellows, that is to say upon the position of adjustment given to stirrup 12.

The rebreathing effect can be checked up accurately by means of a vernier 3B for accurately determining the displacements of the control knob 39 of screw l3.

iii

The various devices for measurement of the flow rate may be included in a casing 40.

In a general manner, while we have, in the above description, disclosed what we deem to be practical and efiicient embodiments of the present invention, it should be well understood that we do not wish to be limited thereto as there might be changes made in the arrangement, disposition and form of the parts without departing from the principle of the present invention as comprehended within the scope of the appended claims.

What we claim is:

1. An inhaler comprising in combination: at least one admission pipe to be united with at least one source of gas under pressure, at least one pipe fitted to be united with one respirator mask, means of distribution in order to control the flow in one of these pipes to the other, said means being movable as a function of the positions of a deformable system subject at least to the action of aspirations of the subject, and constituted essentially by means of two pivoting plates united by flexible shells, means of regulation in order to allow the means of distribution to be put in action for various gamuts of working positions of plates, the former of said means consisting of a regulatable support on which the two plates are pivoted in such a way that the distance between the plates and the means of distribution may vary and that the latter may be set in action for the gamuts of different positions of said plates.

2. An inhaler comprising, in combination: at least one admission pipe to be united with at least one source of gas under pressure, at least one pipe fitted to be united with one respirator mask, means of distribution in order to control the flow in one of these pipes to the other, said means being movable as a function of the positions set by a deformable system subject at least to the action of the inspirations of the deformable system constituted by means of two pivoting plates united by flexible shells, which plates may come in action on the said means and a support bearing the axis of the pivot of said plates, this support being in regulatable position so that the means of distribution may be set in action for the different gamuts of the working positions of said plates.

RENE ETIENNE ROCHETIE.

RENE: DALIGAULT.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date Re. 17,512 McKesson Dec. 3, 1929 743,294 Knowles Nov. 3, 1903 FOREIGN PATENTS Number Country Date 190,807 Great Britain Dec. 29, 1922 212,167 Great Britain Mar. 6, 1924 379,129 Great Britain Aug. 25, 1932 

